As a doctor who also happens to be an end stage renal disease (ESRD) patient, I appreciate this opportunity to reflect on the great strides that have been made to improve the lives of ESRD patients and the steps that still need to be taken to make sure kidney patients have access to the best dialysis treatment possible and the best chance ...
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Your child has an earache. You are worried it is an ear infection. You call the doctor and make an appointment. After all, he needs antibiotics, right?
Maybe not.
We have a real problem of antibiotic overuse in our country--and because we are overusing our antibiotics, many bacteria are getting smarter and stronger. Because ear infections is the diagnosis that kids in the United ...
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Having to confront an indeterminate outcome that might be bad seems to cause more anxiety than having to confront an outcome known to be bad.
In one study, patients requiring colostomies (a rerouting of the passage of stool from the rectum to an opening in the abdomen) that were potentially reversible were actually found to be less happy six months after their operation ...
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From ACOG comes five new cautions, part of the American Board of Internal Medicine Foundation’s Choosing Wisely campaign, to eliminate wasteful and unnecessary medical interventions that can actually cause harm. All the recommendations are evidence-based and have broad consensus.
1. Don’t schedule elective, non-medically indicated inductions of labor or cesarean deliveries before 39 weeks 0 days gestational age. Delivery prior to 39 weeks 0 days has been shown to be associated with an increased risk ...
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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 65-year-old man is evaluated for a 2-year history of daytime somnolence, snoring, and apneic episodes during the night as witnessed by his wife. He does not have blurred vision, tinnitus, or headache. He has no cardiopulmonary symptoms and does not smoke cigarettes. The patient has hypertension for which he takes lisinopril and atenolol.
On ...
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Multi-tasking has never been my forte and so I like to keep my schedule organized. Mondays, I see all of my on-treatment patients. Tuesdays and Thursdays I see new patients in consultation. Wednesdays are reserved for treatment planning and research projects. But Fridays—well, Fridays are usually the best day of the week. Not only is the weekend approaching, with time to spend on my menagerie and the ever present home ...
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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 54-year-old woman is evaluated during a routine examination. She is very concerned by her lack of interest in sexual intercourse. The patient feels like she "just doesn't want to be touched." She used to enjoy intercourse and does not know why she feels this way now, but she acknowledges that it is causing ...
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It's not only about smoking cessation.
As I entered the examination room, J.L., a new patient here for a well visit, was sitting comfortably on the examination table. In his mid thirties, tall, slim and with an athletic build, he had a relaxed, easygoing air about him.
Before entering the room, I had quickly scanned his chart, and noted that in the pre-examination questionnaire, ...
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I recently read a very good article in the New York Times about a patient found to have the classic incidentaloma, a small mass in the adrenal gland. This is estimated to be seen in 4% of abdominal CT scans, and is rarely serious but typically leads to recommendations for additional testing and follow up CT scans to assure that it is not either a metastatic cancer from ...
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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 67-year-old woman is evaluated for a 2-day history of severe muscle weakness. The patient experienced significant weight gain and developed hypertension and type 2 diabetes mellitus 2 years ago. She also reports developing muscle weakness of the lower extremities 6 months ago. Her diabetes is only partially controlled by metformin; her blood glucose ...
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"A comprehensive and extremely useful roadmap for doctors."
-Eric Topol, MD, author of The Creative Destruction of Medicine
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Past 6 Months
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